The fatal tendency of
mankind to leave off thinking about a thing which is no longer doubtful is the
cause of half their errors.
– John Stuart Mill

I

n 1949, the DTP vaccine was
licensed to prevent diphtheria, tetanus, and pertussis (whooping cough) issuing
forth the modern use of vaccines in the prevention of childhood illnesses.
Polio immunization was later introduced to prevent that dread disease. In 1963,
the measles vaccine was licensed and was combined with mumps and rubella
vaccines
to create the MMR vaccine. In more recent times the hepatitis B and chickenpox
vaccines have been developed and incorporated into our healthcare system. Now a
child can expect to receive up to 33 vaccines during their childhood with more
vaccines on the horizon, such as herpes zoster (shingles), West Nile virus,
influenza, pneumococcal, HIV, and many more.

The belief that vaccines are
safe and effective is pervasive in today’s society. The vast majority of the
medical, public, and government communities have a well-established belief
system in the benefits of vaccines. Even children’s books show how important it
is to “get a shot from the doctor to keep us well.” Our belief system is so
ingrained that we look to medical science to create new vaccines to protect us
from everything from AIDS to ear infections.

Unlike almost any other
health-related issue in the free world, governments mandate many vaccines for
the theoretical public good. In the United States, all 50 states require a
large number of vaccinations before children are allowed to attend public
schools or day care centers. Although most states have religious and medical
exemptions, with some having a philosophical exemption, public and medical
officials exert a great deal of pressure to vaccinate. The pervasive attitude
that plagues will return and ravage the western world without everyone giving
their child a full set of vaccinations is a powerful force in modern society.

One of the chief concepts
that vaccine proponents tell us, and that we generally believe in modern
society, is that the use of vaccines is responsible for the virtual elimination
of many childhood scourges that used to ravage the world. We are told, and
assume, that in the 1800s and early in the 1900s many diseases killed a large
number of people, and that vaccines were invented and stopped these diseases
from being a threat. But is this in fact the case? An immunization booklet
produced by the CDC (Centers for Disease Control) states the following:

“Why are baby shots so important? These shots
protect your baby from nine diseases: measles, mumps, rubella (German
measles), diphtheria, tetanus, pertussis (whooping cough), polio, Haemophilus
influenzae type b (Hib disease), and hepatitis B. Are these diseases very
serious? Today we might not think of these diseases as being very serious
because thanks to vaccines, we don’t see them as often as we used to. …
Measles used to kill hundreds – sometimes thousands – of people a year. In
the 1920s, over 10,000 people a year died from diphtheria.”

“Years ago, diphtheria was a widespread and
greatly feared disease. Through the 1920s, it struck about 150,000 people a
year and killed about 15,000 of them. Since then these figures have dipped
considerably, thanks to parents who have gotten their children vaccinated
against this terrible disease. There were only 918 cases in 1960, 435 in 1970
and 128 in 1976. Today, only a few cases occur each year.”

“Before measles vaccine was available, nearly all
children had measles by the time they were 15 years old. An average of
530,000 cases a year were reported in the United States during the 10 years
before vaccine was available. And during each of these years, over 450 people
died because of measles. Now, thanks to the measles vaccine, the number of
measles each year is a fraction of what it was then.”[1]

These statements are
certainly compelling. On the face of it, we cannot help but assume that
vaccines have played a key role in improving all of our lives. But looking
carefully at the evidence over a longer period of time reveals a different
picture of disease evolution and the role vaccines have played. One Swiss
scientist that analyzed data over a longer period of time came to a different
conclusion of what occurred in Switzerland:

“An analysis has been made of the evolution in
Switzerland of mortality due to the main infectious diseases ever since the
causes of death began to be registered. Mortality due to tuberculosis,
diphtheria, scarlet fever, whooping cough, measles, typhoid, puerperal fever
and infant gastro-enteritis started to fall long before the introduction of
immunization and/or antibiotics. The decline was probably due to a great
extent to various factors linked to the steady rise in the standard of living:
qualitative and quantitative improvements in nutrition; better public and
personal hygiene; better housing and working conditions and improvements in
education.”[2]

In that research paper,
several graphs of death rates in Switzerland show massive drops in deaths from
disease long before vaccinations are introduced. One graph shows diphtheria
death rates for children from 0 to 14 years of age peaking at over 200 deaths
per 100,000 in the late 1800s. This is followed by death rates decreasing to
less than 10 deaths per 100,000 near the time of the introduction of the vaccine
in the mid 1930s. There was an apparent 95 percent decrease in diphtheria death
rates before introduction of the vaccine. Another graph within the same study
shows scarlet fever decreasing from 200 deaths per 100,000 in the late 1800s to
virtually zero by the 1930s before drug treatments were introduced. Yet another
graph in the study shows typhoid also decreasing from 50 deaths per 100,000 in
1876 to virtually zero by the 1940s when drug treatments were introduced.

A review of “Childhood’s
Deadly Scourge” states:

“During the last two decades of the 19th
century diphtheria was the leading cause of death of toddlers in the
industrialized world, in some cities killing more than a thousand in a single
year. In contrast, since 1980 fewer than 100 cases have been reported in the
entire United States. Although diphtheria is hardly the only infectious
disease to have thus faded, its story is unique because the early period of
its decline can be directly linked to advances in bacteriologic knowledge and
practice. Between 1880 and 1930 health authorities in New York City were
responsible for much of the practical innovation in the control of diphtheria,
as well as a good share of scientific progress.”[3]

The Vital Statistics of
the United States contains compiled statistics for a wide variety of
information since early in the 1900s. Among those are death rates from all
diseases, including infectious diseases. An introductory statement from the
1937 statistics indicates that death rates from infectious diseases declined
greatly in the early part of the century. These declines occurred well before
the advent of vaccines to treat these conditions.

“The trend in death rates for specific causes,
over the past 20 or 30 years, may be characterized by two general statements.
In the first place, there has been a great reduction in the death rates for
infectious and preventable diseases; in the second place, there has been an
increase in the rates for certain diseases characteristic of older ages.
Greatest proportional rate decreases have taken place for such diseases as
typhoid and parathyroid fever, which has declined from a rate of 23.5 in 1910
to 2.1 in 1937; and diphtheria, which declined from a rate of 21.4 in 1910 to
2.0 in 1937. … The rate reductions for infectious and preventable diseases can
be largely attributed to the development of modern public-health practice.”[4]

From these figures, we can
see that death rates from typhoid decreased by 91% from 1910 to 1937 and death
rates from diphtheria declined by 90.5% during the same time period. The
decrease in diphtheria occurred well before the use of vaccination.

An even a more recent
editorial statement from the Journal of Pediatrics states that proper
sanitation was largely responsible for the early large declines in infectious
diseases.

“… the largest historical decrease in morbidity
and mortality caused by infectious disease was experienced not with the modern
antibiotic and vaccine era, but after the introduction of clean water and
effective sewer systems.”[5]

Again, in a 2001 paper in
the Journal of Infection Control:

“The conquest of infectious disease and the
health revolution it initiated is arguably one of the greatest achievements of
Western civilization. Yet the phenomenon is largely unknown and rarely
taught, even in history courses. Conventional wisdom usually assumes that
conquest of infectious disease can be credited to well-known lifesaving
innovations in medicine such as vaccines, antibiotics, and surgical asepsis.
These icons are truly essential ingredients of modern medicine, and their
contribution to human life and health in this century can never be minimized.
However, except for the smallpox vaccination, which was introduced in 1798 and
made compulsory in England in 1853, the overall contribution of medical
innovations to the health revolution of the 1800s is difficult to validate.
Diphtheria, tetanus, and pertussis vaccine arrived on the scene only after
disease mortality rates already had been reduced significantly; measles,
rubella, and polio vaccines did not become available until the middle of the
20th century, when most infant deaths were the result of other causes. The
same holds true for sulfa drugs and antibiotics. Their contribution is
unequivocal, but they did not affect mortality rates until the 1940s.”
[6]

Another paper published in
the premier medical journal The Lancet in 1977 by the Department of
Community Medicine in the United Kingdom also indicates that vaccines were not
responsible for the decline in disease rates in that country.

“There was a continuous decline [whooping cough
deaths], equal in each sex, from 1937 onward. Vaccination, beginning on small
scale in some places around 1948 and on a national scale in 1957, did not
affect the rate of decline if it be assumed that one attack usually confers
immunity, as in most major communicable diseases of childhood. … The steady
decline of whooping cough between 1930 and 1957 is predictive of a linear
exponential decay characteristic of a general and progressive lessening in the
volume and spread of infection among the susceptible population. With this
pattern well established before 1957, there is no evidence that vaccination
played a major role in the decline in incidence and mortality in the trend of
events.”[7]

The author’s conclusion that
“there is no evidence that vaccination played a major role in the decline in
incidence and mortality” is quite monumental and far different than the general
public perception.

Thomas McKeown who was
Professor of Social Medicine in the University of Birmingham Medical School
between 1950 and 1978, is still regarded as a major social philosopher of
medicine, and known for his important works on epidemiology and the practice and
purpose of medicine. His conclusion was also that diseases were declining well
before medical interventions such as vaccinations came into standard use.

“The distinguished epidemiologist Thomas McKeown
(1912-1988) maintained that reductions in deaths associated with infectious
diseases (air-, water-, and food-borne diseases) cannot have been brought
about by medical advances, since such diseases were declining long before
effective means were available to combat them.”
[8]

Another author shows that
disease and mortality was falling before the advent of vaccines or drug
therapies:

“… in 1869 there were 716 deaths from typhus in
London; by 1885 this had been reduced to 28; and at the beginning of the
twentieth century there was none. Similar declines could be given for other
infectious diseases. Tuberculosis began a remarkable disappearing act.
Killing perhaps 500 out of every 100,000 Europeans in 1845, consumption slowly
but continuously sank to 50 per 100,000 by 1950. Curative medicine played
little part in that transition. The disappearance began before Koch
discovered the tubercle bacillus. By the time antibiotics entered the
picture, TB in cities such as New York had fallen to eleventh place in the
death lists. And the mortality graphs for most of Europe’s fatal crowd
diseases all dived before antibiotics had been marketed. Whooping cough
killed 1400 children out of every million in 1850, but one hundred years later
whooping deaths were less than 10 per million. Scarlet fever behaved in the
same way. Measles, typhus, pneumonia, dysentery and polio all share similar
histories. Their retreat had a dramatic impact on the European population.
By 1900 civilization had lost its biological population check: infectious
disease. After centuries of hostile encounters, humans and microbes found a
new adjustment with little interference from drugs or vaccines. In some cases
the microbe became less virulent (measles and diphtheria) or the human host
more resistant (tuberculosis).”
[9]

In the view of this, how can
the statements made by the CDC on how “thanks to vaccines” diseases are a thing
of the past be correct? Back in 1924 Mark Twain was quoted as saying, “There
are three kinds of lies — lies, damned lies, and statistics.” When Mark Twain
made this statement, his point was that numbers could be manipulated by the
unscrupulous to misrepresent facts, to justify a particular bias, or fulfill a
particular agenda. It is an unhappy fact of modern life that anyone with an
idea can support that idea with statistics. The less the public knows about the
source of the statistics, the more possible it is to have misinformation posing
as scientific results.

Simple statements, such as
“in the 1920s, over 10,000 people a year died from diphtheria”, although
accurate are very misleading. Providing a piece of historical fact without any
real context and mixing it with statements on how vaccines helped cure these
diseases leads the reader to erroneously conclude that vaccines were
instrumental in the massive declines of deaths from these diseases.

The CDC’s statements on
vaccines only provide a few facts and then draw a conclusion on this limited
information. To understand the role of vaccines, we must use the raw
information and analyze it over a long period of time. The Vital Statistics
of the United States provides the most accurate information of death rates
from various causes starting early in the 1900s.[10]Figure 1 is a graph of the death rates from measles, typhoid, scarlet
fever, whooping cough (pertussis), and diphtheria. Both the pertussis and
diphtheria vaccines were made widely available in 1949 and the measles vaccine
was introduced in 1963.

Figure 1.
Death rates from infectious diseases

This graph shows that large
drops in disease death rates occurred long before vaccines were introduced.
From 1900 to 1963, when the measles vaccine was introduced, death rates from
measles had declined from 13.3 per 100,000 to 0.2 per 100,000 – a 98% decrease.
From 1900 to 1949, death rates from whooping cough declined from 12.2 per
100,000 to 0.5 per 100,000 – a 96% decrease. From 1900 to 1949, death rates
from diphtheria declined from 40.3 per 100,000 to 0.4 per 100,000 – a 99%
decrease. These are clear and major changes in the severity of diseases well
before any vaccines were introduced. Close up views (figures 2-4) of the
diphtheria, pertussis, and measles death rates show this dramatic drop well
before vaccination programs began.

Figure 2.
Death rates from Diphtheria

Figure 3.
Death rates from Pertussis

Figure 4.
Death rates from Measles

Similarly, in England and
Wales we find the same decline in disease mortality. The data for the disease
mortality was recorded 50 years earlier than in the United States, beginning in
1850.
[11]

From 1850 to 1968, when the
measles vaccine was introduced, death rates from measles had declined from a
range of 52.11 to 26.6 per 100,000 to 0.11 per 100,000 – a range of 99.8% to
99.6% decrease. From 1860 to 1955, death rates from whooping cough declined
from a range of 43.73 to 60.86 per 100,000 to 0.2 per 100,000 – a 99.5% to 99.7%
decrease. From 1859 to 1940, death rates from diphtheria declined from a range
of 49.2 to 22.7 per 100,000 to 6.77 to 1.83 per 100,000 – a 96.2% to 70.2%
decrease. The exact decrease in mortality is difficult to obtain because the
mortality from these diseases fluctuated from year to year, and the exact
introduction of a vaccination and number of people vaccinated each year is
difficult, if not impossible, to obtain. However, it is clear that death rates
in England did to a large extent decline before vaccinations were widespread.

Figure 5 is a graph
that shows the mortality rate declines in England and Wales. The gap from 1891
to 1900 is because data was not acquired for those specific dates.

Figure 5.
Death rates from infectious diseases in England and Wales

The modern era of
vaccines actually began with the advent of the vaccine against smallpox. Edward
Jenner was aware of the belief that people who contracted cowpox never
contracted smallpox. He hypothesized that inoculating people with cowpox would
immunize them against smallpox. On May 14, 1796, he inoculated an eight-year-old
boy, named James Phipps, with matter taken from a cowpox pustule. Phipps
developed coxpox and quickly recovered. Several weeks later, Phipps was
inoculated with smallpox and did not contract the disease. In 1798, Jenner
reported his work in the book, “An Inquiry into the Causes and Effects of the
Variolae Vaccine.” This book prompted the medical professionals of the time to
adopt the practice of vaccination. The vaccine was introduced in England in
1798. It was later made compulsory in 1853 through the Compulsory Vaccination
Act, and then in 1867, an even more stringent law was passed to enforce
vaccination.

Looking at the raw data
from England during that era
[12],
as shown in Figure 6, we see that despite enforced vaccinations against
smallpox there was no significant decrease in deaths from smallpox. In fact,
three major epidemics during 1857-1859, 1863-1865, and 1871-1872 occurred, even
though there was a high vaccination rate. The last major epidemic in 1871-1872
had death rates of 101.2 and 82.1 per 100,000 people respectively, occurring
just four years after a newer and more strict vaccination law was enacted in
1867.

Another interesting
point is that the smallpox disease cycle of decreased deaths and epidemics
appears closely tied to the scarlet fever disease cycle. Just as there was a
large decrease in scarlet fever deaths after 1885, there was simultaneously a
decrease in smallpox deaths. It is important to remember that death from
scarlet fever, which was the worst of infectious diseases in that era, was
eliminated without any vaccination program.

Figure 7
shows that vaccination coverage had no apparent affect on smallpox deaths. As
coverage fell to from a high of 86% in 1879 to 61% in 1898 there was no
resurgence of smallpox deaths. There was a small increase in smallpox deaths to
7.5 per 100,000 people as vaccine coverage rates again increased to 71.8% in
1902, but there after, as vaccine rates fell to below 40%, there was no increase
in smallpox deaths. In fact, after 1905, deaths from smallpox almost completely
vanished.

We must also remember that
deaths were directly attributable to the smallpox vaccine. Figure 8 shows the deaths per 100,000 that were caused by the
smallpox vaccine. Although the number of people that died from the vaccine is
small compared to the number of people that were killed directly by smallpox,
after 1888 there were years that the deaths from the vaccine was close to or
exceeded that from the disease itself (e.g. 1889 – smallpox: 23, vaccine: 58;
1890 – smallpox: 16, vaccine: 43; 1891 – smallpox: 49, vaccine: 43). After
1905, as can be seen in Figure9, the number of deaths from smallpox and vaccination were very
close to one another. In point of fact, after 1905, a person was almost as
likely to die from the vaccine for smallpox as from the disease itself.Figure
8. Deaths
per 100,000 from cowpox and other effects of vaccination

Another interesting point of
note is that certain diseases that also once killed many people declined and
vanished without any assistance from mass vaccination programs. Typhoid death
rates of 10s per 100,000 each year was not uncommon. Scarlet fever once killed
large numbers of people at a death rate of 100 or more per 100,000 each year.
While quite deadly during their prime, these two “killers” were in effect
eradicated due in large part to advances in hygiene and a better understanding
of germ activity. The Canadian Medical Journal contains the following
statements in an advisory statement:

“Typhoid fever is caused by Salmonella typhi,
which affects only humans, often causing serious systemic illness. The
organism is generally transmitted by the feces or urine of the people with the
disease or those who are the S. typhi carriers. The death rate is
approximately 16% for untreated cases and 1% for those given appropriate
antibiotic therapy. … The incidence of typhoid fever is very low in all of the
industrialized countries. Approximately 70 cases are reported in Canada and
190 in the United States annually. The low incidence of typhoid fever in
these countries is attributable to improved living conditions, better
drinking-water quality and the treatment of sewage. The vaccine does not seem
to play an important role in maintaining this lower incidence. Most
infections occurring in the industrialized countries are acquired elsewhere.
… It is certain that vaccination does not afford adequate protection when
heavily contaminated foods are ingested. … There cannot be too much emphasis
placed on hygiene and food precautions; these measures appear to be the most
effective protection against the disease.”[13]

If the forces of improved
living conditions, better drinking water quality and the treatment of sewage
virtually eliminated illnesses such as typhoid and scarlet fever, then isn’t it
reasonable to consider that other diseases, such as measles and pertussis, would
have had similar fates? An analysis of the death rates for all these diseases
does support this idea. The Conquest of Disease by Thurman B. Rice, MD
from 1932 states:

“The benefit of pure water is expressed not only
by the lowering of the typhoid rate but also in a considerable lowering of
other death rates, and even of the general death rate. … Why has the death
rate [for Scarlet fever] markedly fallen in the days before the cause of the
disease was understood? It must be remembered that a given germ is only part
of the cause of a disease; there are often many other very important
contributing, predisposing, or determining factors. As housing conditions
were improved, as the general laws of sanitation, ventilation, and personal
hygiene came to be better understood; as we came to insist on individual
drinking cups; fresh air in bedrooms, and frequent bathing; as doctors became
more proficient in treating the infection so as to prevent its serious
complications and sequelae; as boards of health became more efficient in the
enforcement of public health laws; as methods of isolation and disinfection
were better understood the death rate declined accordingly.”[14]

Again, the major decline in
mortality rates can be attributed to improvements in proper hygiene, not only at
a societal structural level, but also due to major changes in attitude in
personal hygiene.

“In addition to the seminal and recognized role
of environmental hygiene, a substantial but overlooked component of the health
revolution was the transformation in personal hygiene practices and
cleanliness. The transformation probably started in the early 1800s, became
extremely popular from 1890 to 1915, and has since become an essential feature
of “civilized” behavior in the United States and Europe. It is proposed that
this mass behavioral changes in washing, bathing, laundering, and domestic
hygiene practices contributed significantly to the continuing reduction of
illness and death rates at the beginning of the 20th century.”
[15]

It would appear that, at
best, vaccines could be credited with only a tiny fraction of the overall
decline of disease deaths in the 1800s and 1900s. Because death rates were
declining, it is impossible to say whether vaccines had a real effect or if that
the same forces that caused the majority of the decline would have continued to
have a positive impact. Those forces were primarily that of improved
sanitation, proper personal hygiene, improved diet, and the natural cycles of
disease.

Based on our knowledge that
proper sanitation, improved living conditions, and improved nutrition were the
key factors that caused declines in these diseases, we can ask the question: are
the present deaths and complications from these diseases in people of poor
socioeconomic or compromised nutritional status? Is it possible that the focus
on mass vaccination programs diverted attention from continued improvements in
sanitation and nutrition that could have further reduced or eliminated disease
deaths and complications?

It would seem that the
people who recognized the underlying cause of diseases and instituted better
living conditions, proper water and better sanitation should be recognized for
their remarkable achievements, not the inventors and promoters of vaccines.
This analysis, which is based on historical and scientific studies, is a far
different picture than the one alluded to by the CDC in their vaccine
literature.

Because the focus has predominantly been on medical
intervention, the history of what really caused the decline in disease mortality
is “largely unknown” and “rarely taught”. The information that disease death
declined before vaccination is important in the present day because we need to
pay attention to these underlying causes of infectious disease. We must be ever
vigilant to avoid returning to those disease-causing conditions and to examine
these conditions when disease outbreaks occur. It is an important lesson in how
we should approach disease prevention in third world countries. We should not
forget the words of George Santayana: "Those who cannot remember the past are
condemned to repeat it."

[10]
Vital Statistics of the United States 1937 Part I, U.S. Bureau of the
Census, 1939, pp. 11-12; Vital Statistics of the United States 1938 Part I,
U.S. Bureau of the Census, 1940, p. 12; Vital Statistics of the United
States 1943 Part I, U.S. Bureau of the Census, 1945; Vital Statistics of the
United States 1944 Part I, U.S. Bureau of the Census, 1946, p XXII-XXIII;
Vital Statistics of the United States 1949 Part I, U.S. Public Health
Service, 1951, p. XLIV; Vital Statistics of the United States 1960 Volume II
– Mortality Part A, U.S. Department of Health, Education, and Welfare, 1963,
p. 1-25; Vital Statistics of the United States 1967 Volume II – Mortality
Part A, U.S. Department of Health, Education, and Welfare, 1969, p. 1-7;
Vital Statistics of the United States 1976 Volume II – Mortality Part A,
U.S. Department of Health and Human Services, 1980, p. 1-7; Vital Statistics
of the United States 1987 Volume II – Mortality Part A, U.S. Department of
Health and Human Services, 1990, p. 11; Vital Statistics of the United
States 1992 Volume II – Mortality Part A, U.S. Department of Health and
Human Services, 1996, p. 12; Historical Statistics of the United States –
Colonial Times to 1970 Part 1, Bureau of the Census, p. 58

[11]
Mortality in England and Wales for 95 years as provided by the Office of
National Statistics - Published 1997;

[12]
Written answer by Lord E. Percy to Parliamentary question addressed by Mr.
March, M.P., to the Minister to Health on July 16th, 1923